Abstract
A rapid results initiative (RRI) aimed at increasing male involvement in prevention of mother-to-child transmission (PMTCT) and service uptake among pregnant women at 116 antenatal clinics in Western Kenya was compared at baseline, during the RRI, and 3-months post-RRI. Male involvement increased from 7.4 to 54.2% during RRI (risk difference [RD] 0.47, CI 0.45–0.48) then 43.4% post-RRI (RD 0.36, CI 0.35–0.37). Among HIV-infected women, facility delivery increased from 40.0 to 49.9% (RD 0.10, 95% CI 0.06–0.13) and 65.0% post-RRI (RD 0.25, 95% CI 0.22–0.28). HIV-infected pregnant women linkage to HIV care increased from 58.6 to 85.9% (RD 0.27, CI 0.24–0.30) and 97.3% post-RRI (RD 0.39, CI 0.36–0.41). Time to ART initiation reduced from 29 days (interquartile range [IQR] 6–56) to 14 days (IQR 0–28) to 7 days (IQR 0–20). A male-centered RRI can significantly increase men’s engagement in antenatal care leading to improved partner utilization of PMTCT and antenatal services.
Similar content being viewed by others
References
UN AIDS. UN AIDS Fact Sheet 2015. http://www.unaids.org/sites/default/files/media_asset/20150901_FactSheet_2015_en.pdf Acsessed on 3 Oct 2017.
WHO | Treatment of children living with HIV [Internet]. WHO. http://www.who.int/hiv/topics/paediatric/hiv-paediatric-infopage/en/ Accessed on 25 May 2015.
WHO | Mother-to-child transmission of HIV. WHO. http://www.who.int/hiv/topics/mtct/en/ Accessed on 11 Feb 2105.
Guidelines for Prevention Of mother to child transmission (PMTCT) of HIV/AIDS in Kenya 4th edition, 2012.
UNAIDS/CDC. On the fast-track to an AIDS-free generation. UNAIDS; 2016http://www.unaids.org/sites/default/files/media_asset/GlobalPlan2016_en.pdf Acsessed on 26 Oct 2017.
Unicef Count Down To Zero. http://www.unicef.org/french/aids/files/hiv_pmtctfactsheetKenya.pdf Acsessed on 3 Oct 2017.
Towards the elimination of mother to child transmission of HIV and keeping mothers alive. Minstry of Health, National Aids Control Program (NASCOP); 2012. https://dl.dropboxusercontent.com/content_link/d5Pz7EXnzlKhheWpq4IJbGn30Iu9iDiWxrOwQIGVWUZG8u2TVV1SZ86v4EQUGTHa/file Accessed on 26 Oct 2017.
UNAIDS-Global statistics 2015. UNAIDS; 2016. http://www.unaids.org/sites/default/files/media_asset/20150901_FactSheet_2015_en.pdf Acsessed on 26 Oct 2017.
Countdown to zero-Global Plan towards elimination of new HIV infections among children by 2015 and keeping mothers alive. UNAIDS. 2011; www.unaids.org/sites/default/files/media_asset/20110609_JC2137_Global-Plan-Elimination-HIV-Children_en_1.pdf Acsessed on 26 Oct 2017
Kaplan R, Orrell C, Zwane E, Bekker L-G, Wood R. Loss to follow-up and mortality among pregnant women referred to a community clinic for antiretroviral treatment. AIDS Lond Engl. 2008;22(13):1679–81.
Clouse K, Pettifor A, Shearer K, Maskew M, Bassett J, Larson B, et al. Loss to follow-up before and after delivery among women testing HIV positive during pregnancy in Johannesburg, South Africa. Trop Med Int Health. 2013;18(4):451–60.
Msuya SE, Mbizvo EM, Hussain A, Uriyo J, Sam NE, Stray-Pedersen B. Low male partner participation in antenatal HIV counselling and testing in northern Tanzania: implications for preventive programs. AIDS Care. 2008;20(6):700–9.
GIZ health sector programme blog » achieving health goals through rapid results initiative. http://www.gtzkenyahealth.com/blog3/?p=5463 Acsessed on 23 Feb 2015.
Koo K, Makin JD, Forsyth BWC. Barriers to male partner participation in programs to prevent mother to child HIV transmission in South Africa. AIDS Educ Prev Off Publ Int Soc AIDS Educ. 2013;25(1):14–24.
Van den Berg W, Brittain K, Mercer G, Peacock D, Stinson K, Janson H, et al. Improving men’s participation in preventing mother-to-child transmission of hiv as a maternal, neonatal, and child health priority in South Africa. PLoS Med. 2015;12(4):e1001811.
Ediau M, Wanyenze RK, Machingaidze S, Otim G, Olwedo A, Iriso R, et al. Trends in antenatal care attendance and health facility delivery following community and health facility systems strengthening interventions in Northern Uganda. BMC Pregnancy Childbirth. 2013. https://doi.org/10.1186/1471-2393-13-189.
Tenthani L, Haas AD, Tweya H, Jahn A, van Oosterhout JJ, Chimbwandira F, et al. Retention in care under universal antiretroviral therapy for HIV-infected pregnant and breastfeeding women (‘Option B+’) in Malawi. AIDS Lond Engl. 2014;28(4):589–98.
Aluisio A, Richardson BA, Bosire R, John-Stewart G, Mbori-Ngacha D, Farquhar C. Male antenatal attendance and HIV testing are associated with decreased infant HIV infection and increased HIV-free survival. J Acquir Immune Defic Syndr 1999. 2011;56(1):76–82.
Turan JM, Bukusi EA, Onono M, Holzemer WL, Miller S, Cohen CR. HIV/AIDS stigma and refusal of HIV testing among pregnant women in rural Kenya: results from the MAMAS Study. AIDS Behav. 2011;15(6):1111–20.
Montgomery E, van der Straten A, Torjesen K. “Male involvement” in women and children’s HIV prevention: challenges in definition and interpretation. J Acquir Immune Defic Syndr 1999. 2011;57(5):e114–6.
Larsson EC, Thorson AE, Pariyo G, Waiswa P, Kadobera D, Marrone G, et al. Missed opportunities: barriers to HIV testing during pregnancy from a population based cohort study in rural Uganda. PloS One. 2012;7(8):e37590.
Farquhar C, Kiarie JN, Richardson BA, Kabura MN, John FN, Nduati RW, et al. Antenatal couple counseling increases uptake of interventions to prevent HIV-1 transmission. J Acquir Immune Defic Syndr 1999. 2004;37(5):1620–6.
Aluisio A, Richardson BA, Bosire R, John-Stewart G, Mbori-Ngacha D, Farquhar C. Male antenatal attendance and HIV testing are associated with decreased infant HIV infection and increased HIV-free survival. J Acquir Immune Defic Syndr. 2011. https://doi.org/10.1097/QAI.0b013e3181fdb4c4.
Ampt F, Mon MM, Than KK, Agius P, Morgan C, Davis J, et al. Correlates of male involvement in maternal andnewborn health: a cross-sectional study of men in a peri-urban region of Myanmar. BMC Pregnancy Childbirth. 2015. https://doi.org/10.1186/s12884-015-0561-9.
Byamugisha R, Åstrøm AN, Ndeezi G, Karamagi CA, Tylleskär T, Tumwine JK. Male partner antenatal attendance and HIV testing in eastern Uganda: a randomized facility-based intervention trial. J Int AIDS Soc. 2011;14(1):1–11. https://doi.org/10.1186/1758-2652-14-43.
Byamugisha R, Tumwine J, Semiyaga N, Tylleskar T. Determinants of male involvement in the prevention of mother-to-child transmission of HIV programme in Eastern Uganda: a cross-sectional survey. Reprod Health. 2010. https://doi.org/10.1186/1742-4755-7-12.
Bajunirwe F, Muzoora M. Barriers to the implementation of programs for the prevention of mother-to-child transmission of HIV: a cross-sectional survey in rural and urban Uganda. AIDS Res Ther. 2005;28:2.
Byamugisha R, Tumwine JK, Semiyaga N, Tylleskar T. Determinants of male involvement in the prevention of mother-to-child transmission of HIV programme in Eastern Uganda: a cross-sectional survey. Reprod Health. 2010. https://doi.org/10.1186/1742-4755-9-32.
Kalembo Fatch W, Yukai Du, Zgambo Maggie, Jun Qiu. Male partner involvement in prevention of mother to child transmission of HIV in sub-Saharan Africa: successes, challenges and way forwardFatch. Open J Prev Med. 2012;2:8.
Byamugisha R, Tumwine JK, Semiyaga N, Tylleskär T. Determinants of male involvement in the prevention of mother-to-child transmission of HIV programme in Eastern Uganda: a cross-sectional survey. Reprod Health. 2010;7:12. https://doi.org/10.1186/1742-4755-7-12.
Ditekemena J, Koole O, Engmann C, Matendo R, Tshefu A, Ryder R, et al. Determinants of male involvement in maternal and child health services in sub-Saharan Africa: a review. Reprod Health. 2012;9:32. https://doi.org/10.1186/1742-4755-9-32.
Farquhar C, Kiarie JN, Richardson BA, Kabura MN, John FN, Nduati RW, et al. Antenatal couple counseling increases uptake of interventions to prevent HIV-1 transmission. J Acquir Immune Defic Syndr. 2004. https://doi.org/10.1097/00126334-200412150-00016.
Ditekemena J, Koole O, Engmann C, Matendo R, Tshefu A, Ryder R, et al. Determinants of male involvement in maternal and child health services in sub-Saharan Africa: a review. Reprod Health. 2012. https://doi.org/10.1186/1742-4755.
UNAIDS Strategy 2016–2021. http://www.unaids.org/en/resources/documents/2015/UNAIDS_PCB37_15-18 Accessed on 26 Oct 2017.
Schaffer RH, Ashkenas R. Rapid results!: how 100-day projects build the capacity for large-scale change. 1st ed. San Francisco: Jossey-Bass; 2005.
Schaffer RH, Ashkenas R. Rapid results!: how 100-day projects build the capacity for large-scale change. Hoboken: Wiley; 2011.
Dillabaugh LL, Lewis Kulzer J, Owuor K, Ndege V, Oyanga A, Ngugi E, et al. Towards Elimination of Mother-to-Child Transmission of HIV: The Impact of a Rapid Results Initiative in Nyanza Province, Kenya. AIDS Res Treat. 2012;2012.
Majeed R. Building a culture of results: institutionalizing rapid results initiatives in Kenya, 2005–2009. Princeton: Princeton University [Internet].; 2012. https://successfulsocieties.princeton.edu/sites/successfulsocieties/files/Policy_Note_ID216.pdf. Accessed on 3 Mar 2017.
National Aids Control Council. Kenya, County HIV Service Delivery Profiles. 2014. http://www.nacc.or.ke/images/documents/KenyaCountyProfiles.pdf.
McIntyre J, Gray G. What can we do to reduce mother to child transmission of HIV? BMJ. 2002;324(7331):218–21.
Otoo MN, Agapitova N. Connecting the dots. Increasing the yield on learning programs for capacity development: rapid results initiatives and the capacity for development results framework. World Bank Institute, Learning for Development; 2009 p. 1–16. http://siteresources.worldbank.org/EXTCDRC/Resources/RRA_Paper.pdf?resourceurlname=RRA_Paper.pdf.
Jackson SE, Ones DS, Dilchert S. Managing human resources for environmental sustainability. San Francisco: Jossey-Bass; 2012.
The National Institute of Mental Health. Project Accept (HPTN 043): a phase III randomized controlled trial of community mobilization, mobile testing, same-day results, and post-test support for HIV in Sub-Saharan Africa and Thailand. http://www.cbvct.med.ucla.edu/protocol.pdf.
Acknowledgements
We thank the Kenyan women and men who participated in the study. We acknowledge the important logistical support of the KEMRI-UCSF Collaborative Group and especially Family Aids Care and Education Services (FACES). We gratefully acknowledge the Director of KEMRI, the Director of KEMRI’s Centre for Microbiology, and the Nyanza Provincial Ministries of Health and the provincial and district reproductive health coordinators for their support in conducting this research. We also thank George Owino, Christine Osula, Benta Aloo, Jannes Kodero, and Charles Odoyo for their important contributions to this research. This publication was made possible by financial support from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) through cooperative Agreement, #PS001913 through the U.S. Centres for Disease Control and Prevention (CDC), Division of Global HIV and TB (DGHT). The findings and conclusions in this publication are those of the author(s) and do not necessarily represent the official position of the CDC/Government of Kenya.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflicts of interest
The authors have no conflicts of interest to declare.
Ethical Approval
For this analysis, the program evaluation protocol that allows Family Aids Care and Education Services (FACES) to utilize routinely gathered medical information for program evaluation and dissemination was reviewed and approved by the KEMRI ethical review committee, CDC, and the UCSF Committee on Human Research. In addition, informed consent was not obtained from particiants because these were routine services accessible to all patients at the health facility. To protect patient privacy, all data were de-identified, and access to patient records restricted to authorized health workers.
Rights and permissions
About this article
Cite this article
Akama, E., Mburu, M., Mutegi, E. et al. Impact of a Rapid Results Initiative Approach on Improving Male Partner Involvement in Prevention of Mother to Child Transmission of HIV in Western Kenya. AIDS Behav 22, 2956–2965 (2018). https://doi.org/10.1007/s10461-018-2140-3
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10461-018-2140-3